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. 2020 Nov:34 Suppl 3:S15-S21.
doi: 10.1097/BOT.0000000000001937.

Factors Associated With Mortality After Surgical Management of Femoral Neck Fractures

Sofia Bzovsky  1 , Marianne Comeau-Gauthier, Emil H Schemitsch, Marc Swiontkowski, Diane Heels-Ansdell, Frede Frihagen, Mohit Bhandari, Sheila Sprague; FAITH Investigators; HEALTH Investigators
Collaborators, Affiliations

Factors Associated With Mortality After Surgical Management of Femoral Neck Fractures

Sofia Bzovsky et al. J Orthop Trauma. 2020 Nov.

Abstract

Background: Hip fractures are recognized as one of the most devastating injuries impacting older adults because of the complications that follow. Mortality rates postsurgery can range from 14% to 58% within one year of fracture. We aimed to identify factors associated with increased risk of mortality within 24 months of a femoral neck fracture in patients aged ≥50 years enrolled in the FAITH and HEALTH trials.

Methods: Two multivariable Cox proportional hazards regressions were used to investigate potential prognostic factors that may be associated with mortality within 90 days and 24 months of hip fracture.

Results: Ninety-one (4.1%) and 304 (13.5%) of 2247 participants died within 90 days and 24 months of suffering a femoral neck fracture, respectively. Older age (P < 0.001), lower body mass index (P = 0.002), American Society of Anesthesiologists (ASA) class III/IV/V (P = 0.004), use of an ambulatory aid before femoral neck fracture (P < 0.001), and kidney disease (P < 0.001) were associated with a higher risk of mortality within 24 months of femoral neck fracture. Older age (P = 0.03), lower body mass index (P = 0.02), use of an ambulatory aid before femoral neck fracture (P < 0.001), and having a comorbidity (P = 0.04) were associated with a higher risk of mortality within 90 days of femoral neck fracture.

Conclusions: Our analysis found that factors that are indicative of a poorer health status were associated with a higher risk of mortality within 24 months of femoral neck fracture. We did not find a difference in treatment methods (internal fixation vs. joint arthroplasty) on the risk of mortality.

Level of evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

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